膀胱过度活动症的抗胆碱治疗及其不良反应

Therapy and Adverse Reactions of the Application of Antimuscarinic Drugs for Overactive Bladder

膀胱过度活动症(overactive bladder,OAB)是一种令人烦恼的疾病,它影响着人们生活的质量。病人常常表现为尿急,伴有或不伴有急迫性尿失禁,通常有尿频和夜尿的症状。虽然膀胱过度活动症的病因不是很明确,但是抗胆碱药物作为其治疗的基石,在减少膀胱储尿期的收缩,增加膀胱的容量,起着重要的作用。这类药物具有一定的安全性,副作用小,并且有着相似的疗效。尽管如此,当治疗膀胱过度活动时,抗胆碱药物种类的选择,其治疗的预期利弊平衡也应在考虑之中,尤其是合并有中枢神经系统或者心脑血管系统疾病的老年患者。本文通过查阅国内外新近相关的文献,从受体的选择,临床应用和不良反应等方面对7种抗胆碱药物进行综述。

Oveactive bladder （OAB） is a bothersome condition that affects patients＇ quality of life. Patients present with urgency with or without urinary incontinence and often have urinary frequency and nocturia. The etiology is largely unknown, however, the antimuscarinic agents, as the cornerstone in the management of OAB, play an important role in decreasing the ability of the bladder to contract during the storage phase and so increase the bladder capacity. As a class, these agents are safe and have mild adverse effects and similar efficacy though, it is important to consider the risk/benefit balance of antimuscarinic agents when selecting OAB treatment, especially elderly patients with central nervous system or cardiovascular system disease. We herein review the receptor selectivity, clinical application and adverse event of the seven antimuscarinic agents through retrieving the related literatures in and out of China.